Figure 7.

CS-induced NEC is associated with activation of PKA and epithelial apoptosis. CS bind to the intestinal epithelium. Downstream events include AC generating cyclic AMP. This facilitates activation of PKA, which may disrupt normal cellular homeostasis, allowing increased apoptosis and loss of intestinal barrier integrity. Inhibition of PKA activation is protective against experimental NEC. AC, adenylate cyclase; cAMP, cyclic adenosine monophosphate; CS, Cronobacter sakazakii; NEC, necrotizing enterocolitis; PKA, protein kinase A; p-PKA, phosphorylated PKA.